Door-to-needle time (DTN) is associated with outcome in acute ischemic stroke (AIS) patients, who are eligible to receive intravenous tissue plasminogen activator (IV tPA). Various factors have been shown to impact DTN time including patient-related factors such as initial refusal; hospital-related factors such as awaiting laboratory results; and system-related factors, all potentially affecting clinical outcomes.

This was a retrospective chart review of prospectively collected data through Get-with-the-Guidelines from 01/2015 to 12/2018 at our comprehensive stroke center. Data regarding patient demographics, medical history including vascular risk factors, last known well time (LKWT), arrival time, door-to-CT time, treatment time, admission National Institutes of Health stroke scale (NIHSS), pre-stroke modified Rankin scale (mRS) were analyzed. To analyze differences in medians for continuous variables by ethnicity, the Kruskal-Wallis test was used, and for categorical variables, Fisher’s exact test was used.  

Out of 347 patients (mean age 72 years; 51% men) who received IV tPA, 64% were white and 13% were black. There was no significant difference in median DTN between ethnicity categories (p=0.52). Black patients were significantly younger (mean age of 67 years vs. 74 years, respectively) and were more likely to have a history of hypertension (70% vs. 63%) and congestive heart failure (28% vs. 10%) but no significant difference was noted between the groups with respect to admission NIHSS (10 vs 9), door-to-CT times (15 vs. 14.5 minutes), history of vascular risk factors or LKWT to treatment times.  

We did not find significant differences in the treatment times with respect to IV tPA in patients with AIS based on their race/ethnicity. A small sample size is a limitation of our study and further research into the influence of race/ethnicity on DTN is warranted.